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Protein intake and renal function in children.

M Nakano1, U Alon, S S Jennings

  • 1Department of Pediatrics, Virginia Commonwealth University's Medical College of Virginia, Richmond.

American Journal of Diseases of Children (1960)
|February 1, 1989
PubMed
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High protein diets significantly increase urinary excretion of creatinine, potassium, phosphate, sulfate, calcium, and net acid in adolescents with chronic kidney insufficiency. Low protein diets reduce these excretions.

Area of Science:

  • Nephrology
  • Nutritional Science
  • Pediatric Endocrinology

Background:

  • Chronic renal insufficiency affects adolescents, necessitating understanding of dietary impacts.
  • Protein intake is a critical factor in kidney function and metabolic balance.
  • Renal tubular function is sensitive to dietary modifications, particularly protein levels.

Purpose of the Study:

  • To investigate the specific effects of varying protein intake on renal tubular function in adolescents.
  • To quantify changes in urinary excretion of key metabolites under high-protein and low-protein diets.

Main Methods:

  • Seven metabolic studies conducted on five adolescents with mild, chronic renal insufficiency.
  • Patients underwent four-day periods on either a high-protein diet (HPD) or a low-protein diet (LPD), with constant energy intake.

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  • Urinary excretion of creatinine, electrolytes (potassium, calcium), phosphate, sulfate, and net acid were measured.

    • Main Results:

    • High protein intake significantly increased daily creatinine excretion and clearance rates.
    • HPD led to significantly higher excretion rates of potassium, phosphate, sulfate, and calcium compared to LPD.
    • Net acid excretion was nearly threefold higher with HPD, independent of urinary pH.

    Conclusions:

    • Dietary protein intake significantly influences the urinary excretion of creatinine, potassium, phosphate, sulfate, calcium, and net acid.
    • Adolescents with chronic renal insufficiency show marked changes in tubular function markers based on protein consumption.
    • Protein modification in the diet is a key strategy for managing metabolic balance in pediatric kidney disease.